Costigan D A, Winkelman M D
J Neurosurg. 1985 Feb;62(2):227-33. doi: 10.3171/jns.1985.62.2.0227.
A retrospective autopsy study of 627 patients with systemic cancer disclosed 153 patients with metastasis to the central nervous system (CNS) and 13 patients with intramedullary spinal cord metastasis (ISM). Thus, the frequency of ISM was 8.5% of cases of metastasis to the CNS and 2.1% of all cases of cancer. Bronchogenic carcinoma accounted for 11 cases of ISM, and breast carcinoma and melanoma for the other two. There were two distinct patterns of spinal cord involvement, indicating spread of tumor to the cord by two different routes. In nine of the 13 ISM patients a metastasis was found deep within the spinal cord, unassociated with leptomeningeal carcinomatosis; this most likely resulted from hematogenous spread of tumor from a pulmonary source. In the other four patients there was focal or multifocal direct extension of leptomeningeal metastatic tumor across the pia into the parenchyma of the cord. Only four of the 13 patients had a clinical myelopathy; in three of these four this was the presenting feature of an occult lung cancer.
一项对627例全身性癌症患者的回顾性尸检研究发现，有153例发生中枢神经系统（CNS）转移，13例发生脊髓髓内转移（ISM）。因此，ISM的发生率在CNS转移病例中为8.5%，在所有癌症病例中为2.1%。支气管源性癌占11例ISM，另外两例分别为乳腺癌和黑色素瘤。脊髓受累有两种不同模式，表明肿瘤通过两种不同途径扩散至脊髓。在13例ISM患者中的9例，脊髓深部发现转移灶，与软脑膜癌病无关；这很可能是肿瘤从肺部血行播散所致。在另外4例患者中，软脑膜转移瘤有局灶性或多灶性直接延伸穿过软膜进入脊髓实质。13例患者中只有4例有临床脊髓病；在这4例中的3例，这是隐匿性肺癌的首发特征。
